Low-dose radiotherapy of osteoarthritis: from biological findings to clinical effects-challenges for future studies.
Benign diseases
Clinical application
Inflammation
Osteoimmunology
Translational research
Journal
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
received:
17
08
2022
accepted:
25
11
2022
medline:
27
11
2023
pubmed:
6
1
2023
entrez:
5
1
2023
Statut:
ppublish
Résumé
Osteoarthritis (OA) is one of the most common and socioeconomically relevant diseases, with rising incidence and prevalence especially with regard to an ageing population in the Western world. Over the decades, the scientific perception of OA has shifted from a simple degeneration of cartilage and bone to a multifactorial disease involving various cell types and immunomodulatory factors. Despite a wide range of conventional treatment modalities available, a significant proportion of patients remain treatment refractory. Low-dose radiotherapy (LDRT) has been used for decades in the treatment of patients with inflammatory and/or degenerative diseases and has proven a viable option even in cohorts of patients with a rather poor prognosis. While its justification mainly derives from a vast body of empirical evidence, prospective randomized trials have until now failed to prove the effectiveness of LDRT. Nevertheless, over the decades, adaptions of LDRT treatment modalities have evolved using lower dosages with establishment of different treatment schedules for which definitive clinical proof is still pending. Preclinical research has revealed that the immune system is modulated by LDRT and very recently osteoimmunological mechanisms have been described. Future studies and investigations further elucidating the underlying mechanisms are an essential key to clarify the optimal patient stratification and treatment procedure, considering the patients' inflammatory status, age, and sex. The present review aims not only to present clinical and preclinical knowledge about the mechanistic and beneficial effects of LDRT, but also to emphasize topics that will need to be addressed in future studies. Further, a concise overview of the current status of the underlying radiobiological knowledge of LDRT for clinicians is given, while seeking to stimulate further translational research.
Identifiants
pubmed: 36602569
doi: 10.1007/s00066-022-02038-6
pii: 10.1007/s00066-022-02038-6
pmc: PMC10674008
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1164-1172Subventions
Organisme : BMBF
ID : 02NUK073
Organisme : BMBF
ID : 02NUK017G
Organisme : BMBF
ID : 02NUK050E
Organisme : Bayerische Forschungsstiftung
ID : AZ-1495-20
Informations de copyright
© 2023. The Author(s).
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